How to Give an Injection - A Guide for Gestational Surrogacy
How to give an injection is something you will need to learn as a gestational surrogate mother.
Most gestational surrogacies require giving subcutaneous injections as well as a progesterone injection on a daily basis.
Learn to give yourself Lupron injections, and have your partner study the intramuscular injection sites so that he can give you your progesterone in oil.
Or, if need be, you can do your own IM injections.
The biggest difference between a typical pregnancy and a gestational surrogacy is the amount of injections that will need to be given on a daily basis for several weeks leading up to the embryo transfer as well as through the first trimester of pregnancy.
The following guide should help you prepare for the prospect of these shots, and will help you learn how to give an injection.
Please keep in mind; the following information is for entertainment purposes only. Follow your doctor's advice on how to given an injection.
How to Give an Injection: Drawing Up Medication
The first thing you need to do in order to give subcutaneous injections or a progesterone injection is to draw the medication up into the needle. Here are some tips:
Your estradiol and progesterone in oil will be given via intramuscular injection. You will be give two different sized needles; one for drawing up the medication and one for administering it.
Apply EMLA Cream
EMLA Cream is a topical anesthetic that may be prescribed to you by your reproductive endocrinologist to numb your injection site prior to intramuscular injections. Some women like EMLA cream, others prefer not to use it. You may need to ask your doctor to prescribe it; not all do so automatically.
Apply the cream liberally about one and a half hours prior to your progesterone in oil shot. Cover with a piece of plastic wrap until ready to do your injection. If you do not have EMLA cream, an alternative is ice.
Get Your Supplies Together
You'll need to gather the following supplies to draw up your medication.
Progesterone in Oil Medication Vial (store in fridge)
3 mL Syringe
18g 1½ inch needle
22g 1½ inch needles or 25g 1½ inch needle
Draw Up Medication
First, use an alcohol wipe to cleanse the top of your progesterone in oil vial.
Attach a 18g needle to the top of your syringe. The 18 g needle should be in a package with red or pink writing. Remember that red is the color of a stop sign; you will never use the red needle to inject (because it would hurt!). You only use it it draw up medications.
Take the cap off the needle and fill your syringe with air equal to the amount of medication you will need to draw up. For instance, if you are required to take 2cc progesterone in oil, draw 2cc air into the syringe.
Inject the needle into the vial of medication. Turn the vial and needle upside-down so that the vial is on top and the needle is on bottom.
Express the air from the syringe into the vial. This will form a vacuum. Being careful to extract the progesterone and not any air, draw back on the syringe to fill with the appropriate amount of medication, just a tad more than what is required.
Remove syringe from vial. Draw back slightly and allow a tiny bit of air into syringe. Cap your needle.
Unscrew your 18g needle and replace with your 22g or 25g needle. These should be in a package with gray writing on them. Place your used 18g needle in your sharps container.
Note: if you do not have a sharps container, a thick plastic bottle such as a 2liter bottle will work as well; just make sure to cap your needles.
Take cap off of needle. Express additional air in the syringe until a drop of the progesterone comes out the top of the needle. Cap your needle again. You should have the exact amount of medication required showing on your syringe. (This can take a little practice; its OK if it is off a fraction.)
Warm Your Medication
After your progesterone in oil is properly measured and in your syringe, its a good idea to place the needle in a heating pad to warm it. When you do a progesterone injection, it is like trying to push a marshmallow out of the syringe; very thick and slow.
Heating the syringe slightly will make it smoother. You do not want your progesterone in oil to be hot, just warm. In lieu of the heating pad, you could hold it in your hand tightly for 15-20 minutes.
Never, under any circumstances put your syringe or any portion of your medication into the microwave, oven, or try to heat on the stove top!
If You Mess Up
If you mess up and draw up the wrong amount of medication, simply screw your 18g needle back onto your syringe and put the medication back into the vial.
Start over. This is all a part of learning how to give an injection.
Why Two Needles
Two needles are used for your progesterone injection.
Why? The first one, the larger 18g needle, is used to draw up the medication.
Because this needle is bigger, it is easier to handle when trying to get the correct amount of progesterone in oil.
The smaller needle, the 22g or 25g, will cause much less pain when injected. Also, since this needle has not been used to puncture the medication vial, it remains sharp and will puncture the skin and muscle easier.
When giving subcutaneous injections, the process of drawing up meds is slightly different. You will most likely only be using one all-in-one syringe and needle unit. Because of this, if you make a mistake on the dosage and need to start again, you may want to use a fresh needle so that it remains sharp.
How to Give an Injection: Giving Subcutaneous Injections
Lupron is commonly used in gestational surrogacy and will require a subcutaneous injection. This is done with a small needle that resembles an insulin injection used by diabetics. Most surrogate mothers will be able to give themselves this shot, and will not need the use of a topical cream such as EMLA.
For giving subcutaneous injections, start your quest to learn how to give an injection by locating the correct spot to inject. Find a flabby area of your tummy, about 2 inches from the left, right, or bottom of your belly button. Pinch this area.
Using an alcohol pad, cleanse the area and allow to dry.
Uncap your needle. At a 90 degree angle, push the needle into the area, express the syringe, and then count to 10, allowing the medication to dispense before removing the needle.
Remove the needle, wipe up any drops of blood, recap your needle and place it into your sharps container. Thats it!
View the following video of a woman drawing up and giving herself a subcutaneous injection of Lupron to help you learn how to give an injection:
How to Give an Injection: Intramuscular Injections
Your progesterone in oil and estradiol will be administered via intramuscular injection. This is most easily done with the assistance of a partner, though if your situation requires you to self-administer, that is possible as well.
Intramuscular Injection Sites
First, you will need to determine the best intramuscular injection sites.
The easiest, and least painful is in the buttocks area, in the upper, outer quadrant of either cheek.
This is close to the hip area.
The picture here shows the ideal spot to do your progesterone injection as you learn how to give an injection.
Mentally divide your buttocks into four. The top, outer (right on right cheek, left on left cheek) square is the ideal spot to inject.
Giving the Progesterone Injection
After locating the correct intramuscular injection sites you will use, have your partner cleanse the area with an alcohol pad. Allow to dry.
If the injection is to be given while standing, place all of your body weight on the leg opposite to the hip reciting the injection. Keep both feet on the ground.
Your partner should quickly plunge the needle into the muscular area, sort of like throwing a dart. The entire length of the needle should be pushed in.
Your partner now needs to pull back slightly on the needle to see if he has accidentally hit a blood vessel. Verify this by seeing if there is any blood in the syringe. If there is blood, remove the needle and start the process over. If not, proceed.
Using consistent pressure, have your partner push the medication through the needle. Progesterone in oil is very thick, this could take 30 seconds or longer.
Remove syringe, cap needle, and place in sharps container. Use a paper towel to mop up any bleeding.
After your injection, you will want to rub the spot or apply a heating pad to help prevent hard spots in your injection area.
Alternate hips nightly.
The following video shows a gestational surrogate mother drawing up progesterone in oil and receiving a progesterone injection with the assistance of her friend. View it to help you learn how to give an injection:
How to Give an Injection: Self-Injecting Intramuscular Medications
Though it is easiest to have your progesterone injection administered by your partner, it is possible to do it yourself. The following videos show women drawing up and administering their own progesterone in oil shots.